War Surgery and Medicine
For some years before the war, and prior to the introduction of X-ray examinations at entry, it had been found that the incidence in the Royal Navy was considerably higher than that of the Army and Royal Air Force. From the inception of the New Zealand Division of the Royal Navy the local incidence had caused no particular concern until just before the war, when seven cases occurred in two years in the Achilles. Certain suggestions for the better ventilation of living and working spaces in the Achilles and Leander could not be put into effect owing to the outbreak of hostilities and the employment of the cruisers on active operations with increased complements.
From the end of 1940 X-ray examination of the chest was part of the standard naval recruiting procedure. Of the 117 cases of pulmonary tuberculosis which occurred in male RNZN personnel between 1 September 1939 and 21 December 1946, the chest X-rays had been clear on entry in 87 cases. This indicated that too much reliance should not be placed on the initial X-ray examination. The conditions of shipboard life make it necessary to keep the page 591 closest watch for any signs or symptoms that might point to tuberculosis. Early recognition and segregation of suspects is essential. Repeat X-rays and vaccination would seem desirable. A careful study of the cases occurring in continuous service personnel of the RNZN before and during the war showed that a significantly large number were members of the same initial training classes. The early training period involved closer common contacts than in any subsequent period of naval service, and it was suggested that some of these groups contained individuals from whom the infection was spread.